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a severe form of acute kidney injury that develops in people with severe illnesses, like infections, or with low blood pressure. Patients may need dialysis. Kidney function often improves if the underlying disease is treated successfully.

ADH (AY-DEE-AYTCH):

seeantidiuretic hormone.

albumin (al-BYOO-min):

the main protein in blood. Large amounts of albumin in the urine may be a sign of chronic kidney disease. See urine albumin-to-creatinine ratio.

albuminuria (AL-byoo-mih-NOO-ree-uh):

More than normal amounts of a protein called albumin in the urine. kidney disease.

allograft (AL-oh-graft):

an organ or tissue transplant from one human to another.

Alport syndrome (AWL-port) (SIN-drohm):

an inherited disorder that affects the cell membranes of the kidneys. It generally develops during early childhood and is more serious in boys than in girls. The condition can lead to end-stage renal disease, as well as hearing and vision problems. The common symptoms of this condition are chronic blood and protein in the urine.

amino acids (uh-MEE-noh) (ASSidz):

the basic building blocks of proteins. The body produces many amino acids and others come from food, which the body breaks down for use by the cells. See protein.

amyloidosis (AM-ih-loy-DOH-siss):

material builds up in one or more organs. This material cannot be broken down and interferes with the normal function of that organ. In kidneys, amyloidosis can lead to proteinuria, nephrotic syndrome, and kidney failure.

loss of kidney function that results from long-term use of analgesic, or pain-relieving, medications. Analgesics that combine aspirin and acetaminophen are most dangerous to the kidneys.

anemia (uh-NEE-mee-uh):

a condition in which the number of red blood cells is less than normal, resulting in less oxygen carried to the body’s cells. Anemia can cause extreme fatigue. Anemia is common in people with chronic kidney disease or those on dialysis. See erythropoietin.

angiotensin (AN-jee-oh-TEN-sin):

a substance in the blood that causes blood vessels to constrict, thus raising blood pressure.

antibiotic (AN-tee-by-OT-ik):

a medicine that kills bacteria.

antidiuretic hormone (ADH) (AN-tee-DY-yoo-RET-ik) (HOR-mohn):

a natural body chemical that slows down the production of urine. Some children who wet the bed regularly may lack normal amounts of antidiuretic hormone. Also called vasopressin.

anuria (an-YOO-ree-uh):

a condition in which the body stops making urine.

ARB (arb):

an oral medicine that lowers blood pressure. ARB stands for angiotensin receptor blocker. For people who have protein (albumin) in the urine, it also helps slow down kidney damage.

arteriovenous (AV) fistula (ar-TIHR-ee-oh-VEE-nuhss) (FISS-tyoo-luh):

surgical connection of an artery directly to a vein, usually in the forearm, created in people who will need hemodialysis. The AV fistula causes the vein to grow thicker, allowing the repeated needle insertions required for hemodialysis. Development of the AV fistula takes 4 to 6 months after surgery before it can be used for hemodialysis. The AV fistula is the preferred method of vascular access. See hemodialysis under dialysis.

Arteriovenous Fistula

arteriovenous (AV) graft (ar-TIHRee-oh-VEE-nuhss) (graft):

in hemodialysis, surgical connection of an artery to a vein using a soft, flexible tube, which can be used for repeated needle sticks. See
hemodialysis under dialysis.

Arteriovenous graft

artery (AR-tur-ee):

a large blood vessel that carries blood with oxygen from the heart to all parts of the body.

ATN (AY-TEE-EN): see acute tubular necrosis.

autoimmune disease (AW-tohih-MYOON) (dih-ZEEZ):

disorder in which the body’s immune system attacks and destroys body tissue instead of protecting the body from foreign substances, as it normally does. Examples are Goodpasture syndrome and lupus erythematosus. See lupus nephritis.

B

a procedure in which a tiny piece of tissue, such as from the kidney or bladder, is removed for examination with a microscope.

bladder (BLAD-ur):

the balloon-shaped organ inside the pelvis that holds urine.

blood pressure (BLAD-ur):

the force of blood exerted on the inside walls of blood vessels. Blood pressure is expressed as two numbers. For example, a blood pressure result of 120/80 is said as "120 over 80." The first number is the systolic pressure, or the pressure when the heart pushes blood out into the arteries. The second number is the diastolic pressure, or the pressure when the heart rests.

blood urea nitrogen (BUN) (bluhd) (yoo-REE-uh) (NY-troh-jen):

a waste product in the blood that comes from the breakdown of protein. The kidneys filter blood to remove urea. As kidney function decreases, the BUN level increases.

bruit (broo-EE):

a whooshing sound made when blood flows through a narrow vessel. A bruit in the abdomen may be a sign of renal artery stenosis.

C

hormone produced by the kidneys to help the body absorb dietary calcium into the blood and bones.

calcium (KAL-see-um):

a mineral the body needs for strong bones and teeth. Under certain conditions, calcium may form stones in the kidney.

calcium oxalate stone (KAL-seeuhm) (OK-suh-layt) (stohn):

a kidney stone made from calcium and oxalate.

CAPD (SEE-AY-PEE-DEE):

see continuous ambulatory peritoneal dialysis under dialysis.

catheter (KATH-uh-tur):

a tube inserted through the skin into a blood vessel or cavity to draw out body fluid or infuse fluid. In peritoneal dialysis, a catheter is used to infuse dialysis solution into the abdominal cavity and drain it out again. See peritoneal dialysis under dialysis.

CCPD (SEE-SEE-PEE-DEE):

see continuous cycling peritoneal dialysis under dialysis.

chronic (KRON-ik):

refers to disorders that last a long time, often years. Chronic kidney disease may develop over many years and lead to end-stage renal disease. Chronic is the opposite of acute, or brief.

chronic kidney disease (CKD) (KRON-ik) (KID-nee) (dih-ZEEZ):

any condition that causes reduced kidney function over a period of time. CKD is present when a patient's glomerular filtration rate remains below 60 milliliters per minute for more than 3 months or when a patient’s urine albuminto- creatinine ratio is over 30 milligrams (mg) of albumin for each gram (g) of creatinine (30 mg/g). CKD may develop over many years and lead to endstage renal disease.

abnormal bone hormone levels caused by the failure of the diseased kidneys to maintain the proper levels of calcium and phosphorus in the blood. CKDMBD results in weak bones, a condition known as renal osteodystrophy. CKD-MBD is a common problem in people with kidney disease and affects almost all patients receiving dialysis.

a genetic kidney disease that develops before birth or in the first few months of life. Congenital nephrotic syndrome usually leads to end-stage renal disease and the need for dialysis or a kidney transplant by the second or third year of life.

a waste product from protein in the diet and from the normal breakdown of muscles of the body. Creatinine is removed from blood by the kidneys; as kidney disease progresses, the level of creatinine in the blood increases.

creatinine clearance (kree-AT-ihneen) (KLIHR-ants):

a test that measures how efficiently the kidneys remove creatinine from the blood. Low creatinine clearance indicates impaired kidney function.

cyst (sist):

an abnormal sac containing gas, fluid, or a semisolid material. Cysts may form in the kidneys or in other parts of the body. See medullary sponge kidney, renal cysts, and polycystic kidney disease.

cystine stone (SISS-teen) (stohn):

a rare form of kidney stone consisting of the amino acid cystine.

cystinuria (SISS-tih-NYOO-ree-uh):

a condition in which urine contains high levels of the amino acid cystine. If cystine does not dissolve in the urine, it can build up to form kidney stones.

cystitis (sis-TY-tis):

inflammation of the bladder, causing pain and a burning feeling in the pelvis or urethra.

cystoscope (SISS-toh-skohpe):

a tubelike instrument used to look inside the urethra and bladder. The procedure is called cystoscopy.

D

a condition characterized by high blood glucose, resulting from the body's inability to use blood glucose for energy. In type 1 diabetes, the pancreas no longer makes insulin, and therefore glucose cannot enter the cells to be used for energy. In type 2 diabetes, either the pancreas does not make enough insulin or the body is unable to use insulin correctly. Also called diabetes mellitus.

diabetes insipidus (dy-uh-BEE-teez) (in-SIH-puh-duhss):

a condition characterized by frequent and heavy urination, excessive thirst, and an overall feeling of weakness. This condition may be caused by a defect in the pituitary gland or the kidney. In diabetes insipidus, blood glucose levels are normal. See nephrogenic diabetes insipidus.

dialysate (dy-AL-ih-SAYT):

the part of a mixture that passes through a semipermeable membrane. The wastes from blood that pass into the dialysis solution become dialysate. The term dialysate is sometimes used as a synonym for dialysis solution.

dialysis (dy-AL-ih-sis):

the process of filtering wastes from the blood artificially. Filtering wastes is normally done by the kidneys. If the kidneys fail, the blood must be filtered artificially. The two major forms of dialysis are hemodialysis and peritoneal dialysis.

hemodialysis (HEE-moh-dy-AL-ih-siss):
the use of a machine to filter wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The filtered blood then flows through another set of tubes back into the body.

Hemodialysis

peritoneal dialysis (PAIR-ih-toh-NEE-uhl) (dy-AL-ih-siss):
filtering the blood by using the lining of the abdominal cavity, or belly, as a semipermeable membrane. A cleansing liquid, called dialysis solution, is drained from a bag into the abdomen. Fluid and wastes flow through the lining of the abdominal cavity and remain "trapped" in the dialysis solution. The solution is then drained from the abdomen, removing the extra fluid and wastes from the body. The two main types of peritoneal dialysis are continuous ambulatory peritoneal dialysis and continuous cycling peritoneal dialysis.

continuous ambulatory peritoneal
dialysis (CAPD) (kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee) (PAIR-ih-toh-NEE-uhl) (dy-AL-ih-siss): a form of peritoneal dialysis that does not need a machine. With CAPD, the blood is always being filtered. The dialysis solution passes from a plastic bag through a catheter and into the abdomen. The dialysis solution stays in the abdomen with the catheter sealed. After several hours, the person using CAPD drains the solution back into a disposable bag. Then the person refills the abdomen with fresh solution through the same catheter to begin the filtering process again.

continuous cycling peritoneal dialysis (CCPD) (kon-TIN-yoo-uhss) (SY-kling) (PAIR-ih-toh-NEE-uhl) (dy-AL-ih-siss): a form of peritoneal dialysis that uses a machine. This machine automatically fills and drains the dialysis solution from the abdomen. A typical CCPD schedule involves three to five exchanges during the night while the person sleeps. During the day, the person using CCPD performs one exchange with a dwell time that lasts the entire day.

dialysis solution (dy-AL-ih-siss) (suh-LOO-shuhn):

a cleansing liquid used in the two major forms of dialysis—hemodialysis and peritoneal dialysis. Dialysis solution contains dextrose, a sugar, and other chemicals similar to those in the body. Dextrose draws wastes and extra fluid from the body into the dialysis solution. The term dialysate is sometimes used as a synonym for dialysis solution.

dialyzer (DY-uh-LY-zur):

an attachment to the hemodialysis machine. The dialyzer has two sections separated by a semipermeable membrane. One section holds dialysis solution. The other holds the patient's blood. See hemodialysis under dialysis.

Structure of a typical hollow fiberdialyzer

diuretic (DY-yoo-RET-ik):

an oral medicine that lowers blood pressure by aiding the kidneys in removing fluid from the blood.

dwell time (DY-yoo-RET-ik):

in peritoneal dialysis, the amount of time dialysis solution remains in the patient's abdominal cavity between exchanges. See peritoneal dialysis under dialysis.